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  • Dermatologists have the most training and scientific knowledge to understand cosmeceuticals and skin care products.

  • Using a diagnostic skin typing system helps identify underlying skin issues and facilitates product matching and patient education.

  • Cosmeceuticals and skin care products can be a source of a range of adverse reactions, including irritation and allergy; therefore, proper selection and patient compliance is critical for improved outcomes.


According to recent data, sales in the United States of skin-care cosmeceuticals approach $6.5 billion annually and international sales surpass $10 billion, with forecasts of steady continued growth.1-3 A plethora of skin-care products are currently available to account for this substantial business volume. The vast variety of products, and the often exaggerated associated claims, is so complex that physicians and consumers are often confused about their indications and effectiveness. Dermatologists are uniquely positioned to decipher the product claims and supportive data (or lack thereof) and can guide their patients. They are trained in acne, rosacea, eczema, and many other skin concerns and therefore understand the underlying science of skin care, even if they choose not to sell skin-care products in their offices. Most dermatologists are too busy to spend time discussing skin care with patients. Using a diagnostic methodology to streamline the skin-care prescribing process and educate staff and patients is one approach. The methodology should include routine skin-care advice for facial skin as well as specific instructions for the treatment and healthy maintenance of body skin. Educating the patient on the proper use of sunscreen and medications, such as those for psoriasis, eczema, fungal infections, and wound healing, and how to use those medications in combination with cleansers and moisturizers improves patient compliance and outcomes. This chapter will focus on the issues that should be considered when developing a methodology to prescribe skin-care regimens to treat facial skin issues, but the concept can be easily extended to body skin.


The process of properly diagnosing a patient’s skin issues can be cumbersome and time consuming. One method is by assigning the skin a diagnosis such as acne, rosacea, melasma, contact/irritant dermatitis, eczema, psoriasis, or actinic keratosis and treating it accordingly. However, in many cases, the patient has more than one issue occurring concurrently. For example, many acne patients develop irritant dermatitis from acne medications. The focus here is caring for the skin from a phenotypic approach, which is a simplified way to discuss the various issues that need to be considered when prescribing the proper skin-care regimen. The phenotypic approach focuses on 4 main facial skin issues: skin hydration, inflammation, pigmentation, and skin aging risk factors.



Xerosis, or “dry skin,” is characterized by dull color (usually gray white), rough texture, and an elevated ...

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